The invention relates to pharmaceutical compositions containing drugs which are instable or only sparingly soluble in water, and methods for their preparation. The compositions are characterized by increased water solubility and improved stability.
A large number of drugs is only poorly or sparingly soluble in water so that suitable application forms like drop solutions or injection solutions are being prepared using other polar additives like propylene glycol etc. If the drug molecule has basic or acidic groups there exists the further possibility of increasing the water solubility by salt formation. As a rule this results in decreased efficacy or impaired chemical stability. Due to the shifted distribution equilibrium the drug may penetrate the lipophilic membrane only slowly corresponding to the concentration of the non-dissociated fraction while the ionic fraction may be subject to a rapid hydrolytic decomposition.
Additional xe2x80x9cwater-likexe2x80x9d solvents like low molecular polyethylene glycols or 1,2-propylene glycol are therefore used in the preparation of aqueous solutions of sparingly water-soluble drugs which glycols, however, cannot be considered pharmacologically inert, or the drug is solubilized using surfactants so that the drug molecules are occluded in micells. This solubilization has numerous disadvantages: The surfactant molecules used have frequently a strongly haemolytic effect and the drug needs to pass out of the micell by diffusion after the application. This results in a retard effect (compare B. W. Mxc3xcller, Gelbe Reihe, Vol. X, pages 132ff (1983)).
Accordingly it may be stated that there exists no satisfactory and generally applicable method of solubilization.
For solid drugs it is also important to render the sparingly water-soluble drug water-soluble since a good solubility increases the bioavailability of the drug. It has been described that inclusion compounds, e.g. with urea or complexes of polyvinyl pyrrolidone may improve the solubility of a compound but in aqueous solution they are not stable. Such inclusion compounds are therefore at best suitable for solid application forms of drugs.
This is different when using xcex1-, xcex2-, and xcex3-cyclodextrin which can bind a drug in its ring also in aqueous solution (W. Sxc3xa4nger, Angewandte Chemie 92, 343 (1980)). However, it is disadvantageous that the xcex2-cyclodextrin itself is only poorly water-soluble (1.8 g/100 ml) so that the therapeutically necessary drug concentrations are not achieved.
If a derivative is formed of the cyclodextrin its solubility and therefore the amount of dissolved drug may be considerably increased. Thus, German Offenlegungsschrift 31 18 218 discloses a solubilization method using methylated xcex2-cyclodextrin as monomethyl derivative with 7 methyl groups and especially as dimethyl derivative with 14 methyl groups. With the 2,6-di-0-methyl derivative it is for instance possible to increase the water solubility of indometacin 20.4-fold and that of digitoxin 81.6-fold.
However, for therapeutical use the methyl derivatives of xcex2-cyclodextrin show serious draw backs. Due to their increased lipophility they have a haemolytic effect and they further cause irritations of the mucosa and eyes. Their acute intravenous toxicity is still higher than the already considerable toxicity of the unsubstituted xcex2-cyclodextrin. It is a further serious disadvantage for the practical application that the solubility of the dimethyl xcex2-cyclodextrin and its complexes suffers a steep decrease at higher temperatures so that crystalline dextrin precipitates upon heating. This phenomenon makes it very difficult to sterilize the solutions at the usual temperatures of 100 to 121xc2x0 C.
Quite surprisingly it has now been found that certain other xcex2-cyclodextrin derivatives can form inclusion compounds which also considerably increase the water-solubility of sparing water-soluble and instable drugs without showing the advantages described above.
Subject of the invention are therefore novel pharmaceutical compositions comprising inclusion compounds of only sparingly water-soluble and in water instable drugs with a partially etherified xcex2-cyclodextrin of the formula
(xcex2-CD"Parenclosest"ORxe2x80x83xe2x80x83(I),
in which the residues R are hydroxyalkyl groups and part of the residues R may optionally be alkyl groups, the xcex2-cyclodextrin ether having a water-solubility of more than 1.8 g in 100 ml water.
A partially etherified xcex2-cyclodextrin of formula I is preferably used in which the residues R are hydroxyethyl, hydroxypropyl or dihydroxypropyl groups. Optionally part of the residues R may for instance be methyl or ethyl groups; the use of partially methylated xcex2-cyclodextrin ethers with 7 to 14 methyl groups in the xcex2-cyclodextrin molecule, as they are known from German Offenlegungsschrift 31 18 218 do not come under the present invention. Partial ethers of xcex2-cyclodextrin comprising only alkyl groups (methyl, ethyl) may be suitable in accordance with the invention if they have a low degree of substitution (as defined below) of 0.05 to 0.2.
xcex2-cyclodextrin is a compound with ring structure consisting of 7 anhydro glucose units; it is also referred to as cycloheptaamylose. Each of the 7 glucose rings contains in 2-, 3-, and 6-position three hydroxy groups which may be etherified. In the partially etherified xcex2-cyclodextrin derivatives used according to the invention only part of these hydroxy groups is etherified with hydroxyalkyl groups and optionally further with alkyl groups. When etherifying with hydroxy alkyl groups which can be carried out by reaction with the corresponding alkylene oxides, the degree of substitution is stated as molar substitution (MS), viz. in mole alkylene oxide per anhydroglucose unit, compare U.S. Pat. No. 3,459,731, column 4. In the hydroxyalkyl ethers of xcex2-cyclodextrin used in accordance with the invention the molar substitution is between 0.05 and 10, preferably between 0.2 and 2. Particularly preferred is a molar substitution of about 0.25 to about 1.
The etherification with alkyl groups may be stated directly as degree of substitution (DS) per glucose unit whichxe2x80x94as stated abovexe2x80x94is 3 for complete substitution. Partially etherified xcex2-cyclodextrins are used within the invention which comprise besides hydroxyalkyl groups also alkyl groups, especially methyl or ethyl groups, up to a degree of substitution of 0.05 to 2.0, preferably 0.2 to 1.5. Most preferably the degree of substitution with alkyl groups is between about 0.5 and about 1.2.
The molar ratio of drug to xcex2-cyclodextrin ether is preferably about 1:6 to 4:1, especially about 1:2 to 1:1. As a rule it is preferred to use the complex forming agent in a molar excess.
Useful complex forming agents are especially the hydroxyethyl, hydroxypropyl and dihydroxypropyl ether, their corresponding mixed ethers, and further mixed ethers with methyl or ethyl groups, such as methyl-hydroxyethyl, methyl-hydroxypropyl, ethyl-hydroxyethyl and ethyl-hydroxypropyl ether of xcex2-cyclodextrin.
The preparation of the hydroxyalkyl ethers of xcex2-cyclodextrin may be carried out using the method of U.S. Pat. No. 3,459,731. Suitable preparation methods for xcex2-cyclodextrin ethers may further be found in J. Sziejtli et al., Stxc3xa4rke 32, 165 (1980) und A. P. Croft and R. A. Bartsch, Tetrahedron 39, 1417 (1983). Mixed ethers of xcex2-cyclodextrin can be prepared by reacting xcex2-cyclodextrin in a basic liquid reaction medium comprising an akali metal hydroxide, water and optionally at least one organic solvent (e.g. dimethoxyethane or isopropanol) with at least two different hydroxyalkylating and optionally alkylating etherifying agents (e.g. ethylene oxide, propylene oxide, methyl or ethyl chloride).
Drugs exhibiting a significantly increased water-solubility and improved stability, respectively, after having been transferred into inclusion compounds with the above-mentioned xcex2-cyclodextrin ethers are those having the required shape and size, i.e. which fit into the cavity of the xcex2-cyclodextrin ring system. This includes for instance non-steroid anti-rheumatic agents, steroids, cardiac glycosides and derivatives of benzodiazepine, benzimidazole, piperidine, piperazine, imidazole or triazole.
Useful benzimidazole derivatives are thiabendazole, fuberidazole, oxibendazole, parbendazole, cambendazole, mebendazole, fenbendazole, flubendazole, albendazole, oxfendazole, nocodazole and astemisole. Suitable piperadine derivatives are fluspirilene, pimozide, penfluridole, loperamide, astemizole, ketanserine, levocabastine, cisapride, altanserine, and ritanserine. Suitable piperazine derivatives include lidoflazine, flunarizine, mianserine, oxatomide, mioflazine and cinnarizine. Examples of suitable imidazole derivatives are metronidazole, ornidazole, ipronidazole, tinidazole, isoconazole, nimorazole, burimamide, metiamide, metomidate, enilconazole, etomidate, econazole, clotrimazole, carnidazole, cimetidine, docodazole, sulconazole, parconazole, orconazole, butoconazole, triadiminole, tioconazole, valconazole, fluotrimazole, ketoconazole, oxiconazole, lombazole, bifonazole, oxmetidine, fenticonazole and tubulazole. As suitable triazole derivatives there may be mentioned virazole, itraconazole and terconazole.
Particularly valuable pharmaceutical compositions are obtained when converting etomidate, ketoconazole, tubulazole, itraconazole, levocabastine or flunarizine into a water-soluble form using the complex forming agents of the invention. Such compositions are therefore a special subject of the present invention.
The invention is further directed to a method of preparing pharmaceutical compositions of sparingly water-soluble or water-instable drugs which is characterized by dissolving the xcex2-cyclodextrin ether in water and adding thereto the selected drug as well as optionally drying the solution of the formed inclusion compound using methods known per se. Formation of the solution may take place at temperatures between 15 and 35xc2x0 C.
The drug is suitably added batchwise. The water may further comprise physiologically compatible compounds such as sodium chloride, potassium nitrate, glucose, mannitole, sorbitol, xylitol or buffers such as phosphate, acetate or citrate buffer.
Using xcex2-cyclodextrin ethers in accordance with the invention it is possible to prepare application forms of drugs for oral, parenteral or topical application, e.g. infusion and injection solutions, drop solutions (e.g. eye drops or nasal drops), sprays, aerosols, sirups, and medical baths.
The aqueous solutions may further comprise suitable physiologically compatible preserving agents such as quarternary ammonium soaps or chlorbutanol.
For the preparation of solid formulations the solutions of the inclusion compounds are dried using conventional methods; thus the water may be evaporated in a rotation evaporator or by lyophilisation. The residue is pulverized and, optionally after addition of further inert ingredients, converted into uncoated or coated tablets, suppositories, capsules, creams or ointments.